Provider Demographics
NPI:1346300373
Name:FRIEDMAN, JEFF BARRY (LMFT #90726)
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:BARRY
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:LMFT #90726
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 TULE CT
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:CA
Mailing Address - Zip Code:94517-1210
Mailing Address - Country:US
Mailing Address - Phone:925-949-9754
Mailing Address - Fax:
Practice Address - Street 1:401 ROLAND WAY
Practice Address - Street 2:SUITE 150
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94621-2034
Practice Address - Country:US
Practice Address - Phone:510-839-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF48054106H00000X
CALMFT #90726106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist